Kerionlike lesion of the scalp due to Acremonium kiliense in a noncompromised boy

Jo, Lopes; Lc, Kolling; Neumaier, Walter

doi:10.1590/s0036-46651995000400015

Cited by 9 publications

(5 citation statements)

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“…Five of these cases were reported from the United States (4,8), four each were reported from Brazil (15,16,20,29) and India (6,11,37), two each were reported from Argentina (2, 26) and France (17,19), and one was reported from Hungary (35). Only three of these cases occurred in immunocompromised patients, and the fungus was isolated from heart and brain tissue (15), blood (17), and lung tissue (29).…”

Section: Case Reportmentioning

confidence: 99%

Acremonium kiliense: Reappraisal of Its Clinical Significance

et al. 2011

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A case of Acremonium kiliense peritonitis is described. Diagnosis was established by repeated isolation of the fungus from peritoneal dialysate and by its identification on the basis of morphological characteristics and sequencing of internal transcribed spacer (ITS) regions of ribosomal DNA (rDNA). This report and available literature suggest that A. kiliense may have a greater clinical significance than hitherto recognized. CASE REPORTA 75-year-old Jordanian man with a long history of diabetes mellitus and hypertension developed end-stage kidney disease requiring continuous ambulatory peritoneal dialysis (CAPD). His course of CAPD was largely uneventful except for a single episode of bacterial peritonitis, for which he was hospitalized and treated with parenteral antibiotics, with an excellent response. In January 2010, he became febrile, with clinical evidence of peritonitis, and was admitted to the hospital. The peritoneal fluid was turbid, with a white blood cell (WBC) count of 2.1 ϫ 10 9 /liter. On initial microscopic examination, the presence of fungal elements in the peritoneal dialysate was missed. The peritoneal fluid sample was inoculated into aerobic Bactec blood culture bottles, which yielded a growth after 59 h of incubation. The Gram-stained smear from blood culture bottles showed branched hyphal elements. On Sabouraud dextrose agar (SDA; Oxoid Ltd., Basingstoke, England), the specimen yielded slimy colonies with a pinkish appearance ( Fig. 1). Microscopic examination of the primary culture (isolate Kw441-2010) showed hyaline hyphae, with scanty sporulation. A provisional identification of Acremonium/Fusarium species was made, and the growth was subcultured on Sabouraud dextrose agar and oatmeal agar (OMA; oatmeal [30 g], agar [20 g], distilled water [1 liter]) for further identification and antifungal susceptibility testing. Subsequent cultures of the peritoneal fluid yielded the same fungus on three occasions. A serum sample was obtained for the detection of galactomannan (Platelia Aspergillus enzyme immunoassay [EIA] kit; BioRad, Marnes-la-Coquette, France) and (1-3)-␤-D-glucan (Fungitell; Associates of Cape Cod); the latter test was positive (253 pg/ml). An Etest performed on RPMI 1640 medium supplemented with 2% glucose revealed that the isolate was resistant to amphotericin B and caspofungin but susceptible to voriconazole and posaconazole, with MIC values of Ͼ32 g/ml, Ͼ32 g/ml, 0.064 g/ml, and 0.75 g/ml, respectively. The patient was started on voriconazole, with a loading dose of 400 mg, followed by a maintenance dose of 200 mg, given every 12 h via the oral route. Although the patient showed clinical improvement after 2 weeks of voriconazole therapy, the peritoneal dialysate remained turbid (WBC counts, 2.0 ϫ 10 9 / liter). Abdominal ultrasound examination did not reveal any evidence of intraperitoneal adhesions or organ invasion. Since the response to treatment was not adequate, the Tenckhoff catheter was removed and the patient was temporarily switched to hemodialysis. After 1 week of a...

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Section: Case Reportmentioning

confidence: 99%

Acremonium kiliense: Reappraisal of Its Clinical Significance

et al. 2011

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“…They are known to colonize skin, upper respiratory tract mucosa and sinuses in cats, dogs, horses and cattle (3,7,31). Although these filamentous fungi are common environmental saprophytes, existing in soil, plant debris or air (14), clinical infections occur mostly secondary to prior colonization in individuals with increased host susceptibility (1,18). Following introduction by penetrating trauma or abrasions in immunocompetent individuals, the fungus usually only causes localized infections.…”

Section: Discussionmentioning

confidence: 99%

Systemic Acremonium species infection in a dog

Ballhausen¹,

Geisweid²,

Hartmann³

et al. 2016

Tierarztl Prax Ausg K

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A 2-year-old female Magyar Viszla was referred with fever, lethargy, polyuria/polydipsia, and suspected systemic cryptococcosis. At presentation increased rectal temperature and enlarged lymph nodes were detected. Main laboratory abnormalities included lymphocytosis, eosinophilia, and mildly reduced urine specific gravity. Abdominal ultrasound was unremarkable. Lymph node cytology revealed mycotic infection. Acremonium species was isolated from urine as well as from a popliteal lymph node by fungal culture. Therapy with itraconazol (10 mg/kg p. o. q 12 h) was initiated based on susceptibility testing, but dosage had to be reduced by half due to adverse effects. Despite treatment, the dog developed progressive azotemia. Four months after initial presentation, the patient showed anorexia, lethargy, weight loss, diarrhea, vomitus, neurological signs, and severe azotemia and was euthanized. Acremonium species are emerging opportunistic mould fungi that can represent a potential threat for immunocompromised humans. In dogs, only two cases of systemic infection with this fungal species have been reported so far. This case highlights the fact that systemic fungal infections should be considered as a differential in cases of fever and lymphadenopathy.

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“…that usually causing life‐threatening infections especially in immunocompromised patients, and (iii) Lichtheimia corymbifera , the most isolated in Lichtheimia spp. causing human (sub)cutaneous and systematic infections 14‐21 are included in our study. Even though M irregularis , M hiemalis , L corymbifera and R arrhizus all belong to the subphylum Mucoromycotina , order Mucorales , their pathogenicities exhibit significant diversity.…”

Section: Introductionmentioning

confidence: 99%

Characterization of mitogenomes from four Mucorales species and insights into pathogenicity

Liang¹,

Zhang²,

Xu³

et al. 2021

Mycoses

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Background Mucorales, as one major order of Zygomycetes fungi, can infect human beings and cause serious consequence. We have noticed the pathogenicity of Mucorales is closely related to energy metabolism, while mitochondria play the role of energy factories in almost all biological activities. Methods Virulence of M irregularis, M hiemalis, L corymbifera and R arrhizus were verified in Galleria mellonella larvae, as well as mitochondrial gene copies analysed with RT‐qPCR. Mitogenomes of the four Mucorales species were sequenced based on illumina NovaSeq technology to study their characteristic features and functional regions. Results Variant virulence of M irregularis, M hiemalis, L corymbifera and R arrhizu were verified by clinical retrospective data and our G mellonella infection models, also copies of mitochondrial genes indicated the significant associations with pathogenicity. A total of 274.18 clean reads were generated to be assembled; the complete mitogenomes of the four Mucorales species were obtained with totally different length. After the genomes annotated and compared, M irregularis was found more similar with M hiemalis than those of L corymbifera and R arrhizus, especially the small (rrns) and large (rrnl) subunits of mitochondrial ribosomal RNA (rRNA) genes. The GC content, ncRNAs and the distribution of the SNPs and InDels were also compared, and the GC content rate of fungi seems to be related to the fungal thermal adaptability. In addition, linear mitogenomes of these four Mucorales showed diverse arrangements of orf genes and directionality of some conserved gene elements. Conclusion This study uncovered the pathogenicity variances among the four Mucorales species and the relationship between their mitogenomic features and clinical pathogenicity. Further studies like spatial structure of mitochondrial genomes and the comprehensive analysis of transcription regulation are needed.

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Kerionlike lesion of the scalp due to Acremonium kiliense in a noncompromised boy

Abstract: We report a case of kerionlike lesion of the scalp due to Acremonium kiliense in a boy without underlying disease. Diagnosis was established by direct examination and cultures from pus and scrapings.

Cited by 9 publications

References 11 publications

Acremonium kiliense: Reappraisal of Its Clinical Significance

Acremonium kiliense: Reappraisal of Its Clinical Significance

Systemic Acremonium species infection in a dog

Characterization of mitogenomes from four Mucorales species and insights into pathogenicity

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